Suffering Without Help
September 13, 2012 11:12 AM   Subscribe

20% of Anorexics Are Men. And that number is reportedly rising. "Diagnosis is hard. Finding treatment is even harder. Many residential centers don't admit men, out of a belief that treatment should be sex-specific." Article contains images and descriptions that may be disturbing to those with eating disorders. Single page version here.
posted by zarq (20 comments total) 19 users marked this as a favorite
I remember, about 15 years ago, trying to find books or resources or something on anorexia/bulimia for men, and coming up empty-handed. I tried reading the available texts of the day, all geared towards young women, but I wanted something with which I could more readily identify. It was a terribly lonely place, and I felt like I had to make up my own roadmap. I still struggle daily with body dysmorphia, but at least now I'm eating enough (and keeping it down). We've got a long way to go on this one. Thanks for the link; I'm sharing it around.
posted by mykescipark at 11:41 AM on September 13, 2012 [14 favorites]

Making Weight by Dr. Arnold Andersen is a good introduction to the topic of males with eating disorders that is pretty readable.
posted by fraxil at 11:46 AM on September 13, 2012

Eesh, horrible - I couldn't get very far through that. I had no idea the proportion was so high. Anorexia is such a horrendous disease, and it seems like it can hit anyone for any reason - I did a course on psychological disorders at university, and beyond saying "body image portrayals in the media probably have something to do with it", it seemed like the consensus was just that we don't know what's causing it.
posted by ZsigE at 11:51 AM on September 13, 2012

The first person I ever suspected of suffering from anorexia was a guy. He'd gotten into the extreme weight maintenance that the wrestling team did (It grows out of gaming the weight class system) and it interacted badly with his existing issues I guess. He exhibited just about all the textbook behaviors (and matched the pattern I saw with some of the girls I knew later who'd been actually diagnosed.) I'd kind of wanted to bring it up with him, but couldn't think of any way that wouldn't just make things worse.
posted by Karmakaze at 11:51 AM on September 13, 2012

Thanks for the link; I'm sharing it around.

You're very welcome.

I have a subscription to the print magazine through my office, and have been waiting for them to post this online for three weeks so I could post it here and send it to friends. Every few days, I've been checking GQ's website looking for an article on anorexia, and instead have been finding a ton of images of male models and athletes in incredible shape, as well as a whole bunch of articles on their front page about the merits of weight loss and (at times extreme) exercise. They have a writer doing the P90X program and blogging about it.

I'm glad that the article mentions that GQ and other magazines aren't blameless. But damn, the disconnect between this article and the rest of the magazine is strong.
posted by zarq at 12:05 PM on September 13, 2012 [1 favorite]

I'm glad that the article mentions that GQ and other magazines aren't blameless. But damn, the disconnect between this article and the rest of the magazine is strong.

You get the same effect in women's magazines, which may feature a piece like this right next to diet plans and cake recipes and plastic surgeon ads.

I've always been fascinated by anorexia; in many ways I feel like I just barely missed having it (got different and milder disorders instead) but the type of thinking anorexics describe, the obsession, the body hatred...all very familiar. I could be there so easily. I know there's women (and maybe men too) all around me who probably are there but not talking about it.
posted by emjaybee at 12:11 PM on September 13, 2012 [3 favorites]

I read a book at the library called "The invisible man : a self-help guide for men with eating disorders, compulsive exercising and bigorexia" by John F. Morgan, it was an interesting read. I
posted by Harpocrates at 1:06 PM on September 13, 2012

I suffered from what I believe was at least a mild anorexia in my first year in college. I ate only yogurt for six months and only once or twice a day. For me it was entirely a mental state brought on by insecurity about my place. For me, anyway, it wasn't insecurity related to my physique. Rather insecurity related to my place in the college and in my life at the time. In retrospect I think I was trying to hurt myself/get attention, if I was to look at it completely honestly.

Fortunately I dropped out of the school, took a few years to figure myself out and am healthy now. (This was 13+ years ago). At the time I didn't have any way to explain it or support me, as it is and really still is considered a female disease. I didn't even really acklowedge what was happening until Daneil Johns of Silverchair (of all people), came out and admitted to having Anorexia Nervosa. In his story I found alot of common ground and actually found it easy to pull out of after that.
posted by dogbusonline at 1:42 PM on September 13, 2012

From a commenter who wishes to remain anonymous:
I don't have an eating disorder. But at several points in the GQ article I felt painful stabs of recognition. The 21-year-old kid who talks about god. The ascetic.

Parts of my personality are very obsessive. In most cases I don't have the discipline to stick to an extremely rigorous plan, but I definitely wish I had it. I like eating food, food is delicious. But the idea of a meal plan laid out ingredient by ingredient, dish by dish, at every meal of every day, that kind of predictability, regularity, and rigor — it's a beautiful notion. I guess if I had just a smidgen more of Property X, whatever it is, I could have developed an eating disorder.

I have a different problem. Several years ago I almost died — in retrospect, almost killed myself. A disorder had destroyed my ability to absorb an important nutrient from food. Unbeknownst to me, my body's stores of this nutrient were slowly running out, like sand in an hourglass.

The process was very gradual, but it was the mindset that I find the most remarkable and still so eerily familiar. The symptoms began with small things: minor but pervasive numbness in my feet, like they'd fallen asleep and didn't completely go back to normal. The feeling waxed and waned, sometimes accompanied with the sensation of pins and needles. Sometimes I didn't know if I was just imagining it. I started to believe that I also felt it in my fingertips: that strange, filthy feeling of ink on your fingers when you read a cheap newspaper. Or was I just reading the newspaper more often?

Then the fatigue appeared. It was a strange kind of fatigue. I had trouble going up stairs, but I didn't get winded. Breathing was useless, it was an unnecessary process of a burdensome body. Exertion felt like walking through molasses: the harder you tried, the harder it got. The steeper the slope, the longer I had to climb, and the slower I climbed with each week.

I developed an instinctive eye for very mild slopes. I think some elderly might have a similar "sixth sense." It was a new way of seeing the world, a hyper-awareness of the ground about ten feet ahead of me. The barometer in my chest instantly informed me about the exertion from even the slightest slope. My world began to narrow. I began to eyeball the distance from the parking space to the door, the distance from one place to sit down to another.

I realized that I was very ill. I spend hours at work browsing for diagnoses on the Mayo Clinic website. Which one did I have, MS or pulmonary hypertension? (Neither.) What would my life look like with either of those two? How long would I live?

Strangely, but somehow naturally, intuitively, I didn't go to the doctor. I thought I would get better on my own. Every time I'd been sick before worked like that. It sucks, and then it gets better. You just have to be patient and strong. Plan B was the emergency room. I just had to feel bad enough, bad enough for doctors to rush in and take care of me, save me. But it's amazing how bad you can get before you feel bad enough.

I had graduated from college two years before that and failed to launch. I had been a bright and lucky kid, I went to a good school, and then the track reached an end. My life was a series of meaningless, disconnected vignettes: jobs that were a bad fit, cold rented rooms, stranger roommates. It was a directionless twilight existence. Illness gave my life a direction (down). It brought things into sharp focus (survive today). It gave me a goal (get better). I began to categorically seek out low-salt and sodium free foods to take control of the hypothetical heart problem with which I had diagnosed myself. Uselessly, I started taking an iron supplement.

Around Christmas my vision began to blur, a change in my state that I regarded with amusement. I was reading A Voice Through a Cloud, the autobiographical Denton Welch novel about his struggles as a young man with a bad spinal injury in 1930s England. Ironically, the novel reaches a cliffhanger ending at its brightest point: it was the part Welch had written in a delirious frenzy on his own deathbed. And that matched the way I felt: that it's always darkest before the dawn. That you had to hit bottom before you started on the way up. That you had to feel bad enough. And until that happened, you had to be patient and disciplined and good, and take that ride all the way to the end of the line.

In the end, yes, I sought treatment. I mailed in a check for the past-due amount on the (craptacular) individual insurance plan I had at the time and had someone take me down to the nearest emergency room. The doctor congratulated me on the fact that I was alive, despite every sign to the contrary, and thus began my recovery. I got to stay at the hospital for a week and eat delicious hospital food (rigorous meal plan, every calorie and milligram of sodium accounted for, breakfast, lunch, and dinner). It was like a family vacation that I hadn't taken since childhood. It was a new lease on life.

It's a little frightening that my scenario actually played out exactly how I thought it would. I became extremely ill, I went to the emergency room, and I recovered completely. And it wasn't MS. And I can lead a normal life. And I didn't even have to pay for anything in the end (thank those well-off suburban hospitals with good charity programs).

But I could've died. I could've lived with extensive permanent damage. (Some of my damage is permanent, but it doesn't affect my quality of life much.) I appreciate it, of course, but I wish I appreciated it more. It's so easy to take good health for granted. All I remember is the sense of cool detachment that prevailed when, day by day, I lost more and more feeling in my limbs, and my world became more and more restricted: the walk to the car, the walk downstairs, and finally my room. That satisfaction and purity of purpose is comfortable and terrifying at the same time. It's terrifying because I know that I can go comfortably into that good night, that it feels good to skate on thin ice, and the thinner the ice, the better it feels. It's terrifying because I know that I'm still the same way inside, that this deadly patience is a part of me forever.
posted by restless_nomad at 1:47 PM on September 13, 2012 [15 favorites]

I'd expect the real percentage to be higher than any statistical estimate. When a disease is associated with women so strongly that many people are under the mistaken impression that it's an exclusively female condition, men will tend to be more inhibited about seeking treatment. The same could be true with breast cancer, although I wouldn't expect there to be much inhibition there since everyone realizes that cancer is extremely serious. In contrast, it's fairly easy (not appropriate, but easy) to make light of anorexia.

It would actually be odd if there weren't a significant portion of anorexics who are men. We're all familiar with the idea that women are socialized to perceive an unrealistically thin body type as an ideal. Well, the same kinds of waif-like bodies are seen in male fashion models. Even if men are less likely than women to read fashion magazines, you still end up seeing those kinds of ads in magazines (of all kinds), on billboards, in clothing stores, etc. Interestingly, the media present both women and men with inconsistent messages about their ideal body types: the female ideals are very thin and yet voluptuously buxom, while the male ideals are very thin and yet strappingly muscular.
posted by John Cohen at 1:47 PM on September 13, 2012 [3 favorites]

(It grows out of gaming the weight class system)

Which, by the way, should totally be changed. While any system that categorizes wrestlers by weight is going to be at least a little vulnerable to gaming, I think there's a peculiar effect of having the specific boundaries between weight classes known in advance that tempts people to try to be the heaviest person in the next-lowest class.

One possible alternative: Weigh people when they show up to the tournament; sort them by weight, and group them into classes by quantile. There's no discrete weight class boundary to duck under in this scheme.
posted by Jpfed at 1:54 PM on September 13, 2012 [6 favorites]

Sigh, oh Western culture. We have some problems. It's pretty impressive that we can have epidemics of eating disorders and obesity at the same time.

My boyfriend was a pretty severe anoretic in high school.

We met online while I was in Afghanistan, and one of the things I picked up near the end of my tour was (I think now) the beginnings of an ED. I limited myself to just eating breakfast, and as little of that as possible. A typical day would be like... a couple sausage links and a breakfast bar or a little pre-packed cereal cup thingy.

It felt good, to be honest. The ever-present hunger felt like virtue in my gut. That sounds (and is) really melodramatic, but I dunno, it's honest at least.

Deployment is a mentally weird place to be anyway, so I guess it got hard to tell what was normal and what wasn't when I could be and was under fire on a somewhat regular basis.

We both put on weight in the depths of poverty in Florida. We've both been working on trying to be healthy no that we're re-assembling our lives in Minnesota.

I still miss the feeling sometimes, though. And I sure as hell miss feeling attractive.
posted by kavasa at 2:05 PM on September 13, 2012 [5 favorites]

Residential treatment for teens really needs to be gender-segregated, in my opinion as one who had same, but there need to be enough residential treatment beds for teen boys.

In general, eating disorders are seen so much as a disease of middle-class and rich white women that every other population is routinely marginalized, which is shit.
posted by Sidhedevil at 3:21 PM on September 13, 2012

And I strongly identify with the anon MeFite's experience! I have been having a digestive problem that limits my nutritional intake and absorption, and it's absolutely made my brain go haywire the same way it did when I was a teen. Not eating makes your brain more resistant to eating, and to caring for your health in general. Harriet Brown discusses a lot of the latest research on this in her book Brave Girl Eating.

Right now my husband has to tell me to eat, because my hunger is broken. Not just the appestat function, but the cognitive process around self-nourishment in its entirety. It is freakish and, as the anon described so well, hypnotic.
posted by Sidhedevil at 3:27 PM on September 13, 2012 [2 favorites]

This was painful to read. One of my dearest friends (a female) has been to that treatment facility in Denver, and needed to stay longer during her latest admission, but her insurance wouldn't cover more than 90 days. She is somewhat better, but still has a long way to go. She's boasted that she would "forget" to bring her scale in to her doctor, and still won't keep any food in her apartment. Anytime we eat someplace, I fear that she is going to go home and puke it all up. Her teeth are a mess, and she wears multiple layers of clothes to hide how dreadfully skinny she is. I don't even comment on it anymore.
posted by computech_apolloniajames at 5:21 PM on September 13, 2012

Current estimates suggest it's closer to 20 percent and rising fast: More men are getting ill, and more are being diagnosed. (One well-regarded Canadian study puts the number at 30 percent.)
posted by Decimask at 6:37 PM on September 13, 2012 [1 favorite]

In general, eating disorders are seen so much as a disease of middle-class and rich white women that every other population is routinely marginalized, which is shit.

It is so hard to find places to refer male clients for eating disorder treatment! We have a couple of good facilities in this region (US Southeast) but there aren't male beds; in fact, I've had patients tell me "I won't go to [facility] because it's all rich white teenagers." Whether or not that's true, there's also an internalized barrier to treatment when the general image of eating disorder is a waifish white adolescent female with parents paying cash.

Finding ED treatment for men, for middle-aged women of color, for people with ordinary insurance or Medicare/Medicaid, and for transgender clients is really tough.
posted by catlet at 8:04 PM on September 13, 2012

Thank you for posting this. I know a lot about privileged white anorexic girls and women, having watched my sister, but not so much about the rest of anorexia's victims. Eating disorders don't discriminate.
posted by swerve at 10:19 PM on September 13, 2012

I've always suspected that the prevalence of male anorexia is much, much higher than (self) reported. Throughout my life most of my social circles revolved around figure skating, long distance running, indie music, art, and the culture industry. In each of those environments I had male friends and acquaintances who exhibited text-book symptoms of full-blown eating disorders, mostly anorexia. In fact, my first serious high school boyfriend developed functional anorexia. I always felt like all of men must have been living in a special flavor of hell, where they could become skeletal and yet be told all of their physical and psychological symptoms weren't really a sign of what they themselves likely suspected deep down inside they were dealing with. What a lonely place.
posted by stagewhisper at 10:26 AM on September 14, 2012

NBC did a news story on male anorexia earlier this year. They link to some good resources, including this 2007 study that indicates at least 25% of anorexia sufferers in the US are male. Scary.
posted by bluefly at 6:09 PM on September 14, 2012 [1 favorite]

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